| NPI | 1265971147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA HARVEY President 229-829-0294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2023-07-12 |